Spencer W Smith, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2957 Issued in WI

Practice address

2400 Marshall St
Wausau, WI 54403-6738

Phone

(715) 848-4300

NPI assigned

Aug 29, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1659929826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 JELINEK AVE APT 3",
            "city": "SCHOFIELD",
            "state": "WI",
            "postal_code": "544763525",
            "telephone_number": "920-323-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MARSHALL ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036738",
            "telephone_number": "715-848-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SPENCER",
        "middle_name": "W",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-29",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "2957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chloe L Smith, RN
• Judith Smith, OTA
• Kristi Smith, LPC
• Sierra H Smith, APSW
• Sierra L Smith, CMA
• Jonathon A Snider, PSY.D.
• Jonathan Aaron Snow
• Veronica Elizabeth Snow, RN, BSN
• April Sobiesczyk, RN
• James Anthony Sobolewski, DDS

• Physical Therapy Assistant in Wausau, WI
• Providers in Wausau, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.